Prognostic factors in patients with head and neck squamous cell carcinoma with cN3 neck disease: a retrospective case-control study

Abstract

Objective. This study examined prognostic factors in patients with head and neck squamous cell carcinoma with advanced neck disease. Study Design. The records of 191 patients with previously untreated head and neck squamous cell carcinoma and metastatic cervical lymph node (LN) >6 cm (cN, n = 70) and 3.01 to 6 cm (control, n = 121) in the greatest dimension were reviewed. Univariate and multivariate analyses were used to identify factors associated with disease-free survival (DFS) and locoregional control (LRC). Results. In the cN3 group, independent variables for DFS were age, active drinking, LN size, and extranodal extension (P < .05), and that for LRC was age (P = .025). In the control group, independent variables for DFS were tumor location and differentiation and LN bilaterality (P < .05), and that for LRC was LN bilaterality (P = .011). Conclusions. The survival of cN3 patients is affected by host and nodal characteristics including age, drinking, nodal size, and extranodal extension.